Protective effect of sildenafil and dexpanthenol on i̇ntestinal i̇schemia reperfusion i̇njury developing result of pneumoperitoneum in rats

Aim: Purpose of this study is investigate to protective effect of sildenafil and dexpanthenol on intestinal ischemia reperfusion injury developing result of pneumoperitoneum in rats. Methods: İn this purpose, animals were randomized into five groups (n=35). Rats in the control group were subjected to only anaesthesia (K, n=7). İn group II. (PP, n=7), III. (S, n=7), IV. (D, n=7) and V. (D+S, n=7); pneumoperitoneum was maintained for 60 minutes at a pressure of 12 mmHg with CO2. In the groups III., IV., V.; Sildenafil (1 mg/kg, PO), Dexpanthenol (500 mg/kg, IP) and Sildenafil+Dexpanthenol were administired before the pneumoperitoneum, respectively. Animals were killed 60 minutes after the desufflation. Blood samples were collected for determine of plasma Malondialdehyde (MDA), Total oxidant status (TOS) and Total antioxidant status (TAS) levels. The terminal ileum, left liver lobe, sigmoid colon and parietal periton were removed for histopathological examination. MDA, TOS and TAS values were determined in tissue samples. Results: The plasma TOS levels and OSİ (oxidative stress index) were found significantly higher in all groups then control group due to oxidative stress (TOS: p=0.003, OSİ: p=0.004). There were no significant differences between groups for plasma MDA levels (p=0.69). While there were no significant difference in control groups compared with all groups for plasma TAS levels, S + D group value was found significantly higher than S group (p = 0.007). MDA values were found higher in all pneumoperitoneum groups but there were no statistically significant difference between groups (p> 0.05). İleum MDA value was significantly lower in group D compared with the PP group (p = 0.004). While there was no significant difference between the control and PP group, D and S + D groups TAS values of colon tissue were significantly higher than PP group (p = 0.002, p = 0.004). The liver and small bowel histological injury scores that due to oxidative stress induced by pneumoperitoneum were significantly higher in the PP group compared with the control group (p = 0.001). Histopathological damage scores of liver and small intestine were found significantly lower in S, D and S + D groups compared with the PP group (p <0.001). There were no histopathological damage on sigmoid colon and parietal periton due to oxidative stress caused by pneumoperitoneum. Conclusions: While the pneumoperitoneum induced ischemia and reperfusion injury is apparent in the liver and small intestine, it's seems safer for colon tissue at the same pressure and time. Seperately or combined sildenafil and dexpanthenol pretreatment have a protective effect against ileal and liver damage due to intestinal ischemia reperfusion induced by pneumoperitoneum in the rats. Key Words: Pneumoperitoneum, İschemia-reperfusion, Sildenafil, Dexpanthenol